Completed Research

A systematic review was undertaken to examine the extent of inequalities in prostate cancer outcomes based on geographic location and other indicators of disadvantage (e.g. socio-economics, literacy). Consistent patterns identified by the review were that PSA testing was more common in urban and affluent areas; prostate cancer incidence was higher in urban and affluent areas; men in rural and disadvantaged areas had greater risk of advanced stage prostate cancer and higher prostate cancer mortality; and men in urban and affluent areas had higher survival and greater access or use of definitive treatment services.

A commercial research opportunity arose to conduct an Australian-first project on the financial impact of prostate cancer. Data from existing sources and an online survey of men with prostate cancer were analysed. Results helped to draw attention to the high out-of-pocket expenses and subsequent impact on men diagnosed with prostate cancer.

Research impacts

Commissioned report for the PCFA, “The Financial Impact of Prostate Cancer. Final Report, August 2013”.

Published journal article – Gordon LG, Walker SM, Mervin MC, Lowe A, Smith DP, Gardiner RA, Chambers SK. Financial toxicity: a potential side effect of prostate cancer treatment among Australian men. Eur J Cancer Care, 2015. DOI: 10.1111/ecc.12392. This article has an Altmetric score of 67 which places it in the top 5% of all research outputs scored by Altmetric. It was tweeted 12 times with an upper bound of 27,285 followers.

Presented the research in national and international forums including the Gold Coast Health and Medical Research Conference (2013, 2015); Prostate Cancer World Congress, Cairns (2015); invited plenary 5th HTAsiaLink Annual Conference, Singapore (2016); Urological Society of Australia and New Zealand (2016); GenesisCancer Forum (2016); and invited workshop on economic modelling at the International Society for Pharmacoeconomics and Outcomes Research-Australian Chapter conference (2016).

Research study with three cohorts of men with prostate cancer was undertaken to assess the validity of the single-item Distress Thermometer to detect distress in men, and to establish the optimal cut-off score to indicate high distress. The study identified that the Distress Thermometer is a valid tool to use, with an optimal cut-off of ≥4 to indicate distress.

This research used qualitative approaches to explore what it means to be young and have prostate cancer. Focus groups with key stakeholders (health professionals and men with prostate cancer) were conducted, followed by semi-structured interviews with men with prostate cancer, to explore what it means to be young in relation to prostate cancer. This study highlighted masculinity as a central concept in how men define young and respond to prostate cancer.

Research impacts
• Published journal article – Chambers SK, Lowe A, Hyde MK, Zajdlewicz L, Gardiner RA, Sandoe D, Dunn J. Defining young in the context of prostate cancer. Am J Men’s Health. 2015; 9(2):103-114.
• Based on results from this research a masculinity scale that represented men’s own views about masculinity in facing a chronic disease such as prostate cancer.

This research tested the measurement properties of the newly devised Masculinity in Chronic Disease Inventory (MCD-I). Results indicated that this new masculinity inventory showed promise and also distinguished between men with severe vs. moderate to mild erectile dysfunction, and men who had sought support for sexual concerns vs. those who had not. A second analysis of this data showed that less than one-third of men had sought help for their sexual concerns after prostate cancer treatment, and men with severe erectile dysfunction were least likely to do so. Masculinity contributed significantly to men’s decisions to seek medical help for their sexual concerns.

Created an MCD-I scale package which describes scale development and scoring instructions.

Presented results at national forums including the ANZUP Annual Scientific Meeting (2015, 2016) and Gold Coast Health and Medical Research Conference (2015), and international forums including International Psycho-Oncology Society Congress Dublin (2016).

Further validation of the MCD-I will occur in 2017 with a men with chronic disease and as well as prospective studies of men with prostate cancer.

This study investigated the unmet physical, emotional, practical or sexual needs of men with localised prostate cancer in the first year after diagnosis. The top unmet need was in the sexuality domain. In the past, men had most often gone to a doctor for their concerns (51%). Men who were older in age, had lower education, and higher depression were less likely to seek support.

The Centre developed and tested a generic health economics model to assess cost-effectiveness of new and existing treatments or services for men with prostate cancer. PCFA obtained $150,000 of sponsorship from the Steadfast Foundation and Bayer to support publication of this model as a monograph in 2016, titled Economic Modelling of Healthcare Services for Prostate Cancer. PCFA disseminated this model nationally and it is now available on their website. Results of this work will underpin PCFA’s future advocacy work with Government and the Department of Health including, for example, an item number for prostate MRI.

An evidence-based psychosocial model of care for prostate cancer patients and their partners, ProsCare, was developed to provide guidance to practitioners in delivering an optimal multi-disciplinary approach for psychological care for men with prostate cancer and their partners. The model is now published as a monograph and is publicly available on PCFA’s website. In 2014, the International Psycho-Oncology Society submitted ProsCare to the European Taskforce on Standards and Accreditation for Prostate Cancer Care Units as a best practice model of proposed care. ProsCare is listed as a key resource on the International Cancer Control Partnership Portal hosted by the Union for International Cancer Control.

A prostate cancer-specific distress screening tool was developed based on Centre research which tested validity of the Distress Thermometer and identified an optimal cut-off score to detect distress. GU trained PCFA prostate cancer specialist nurses to use this tool in practice settings.

Interviews and focus groups were conducted with prostate cancer support group leaders nationally to chronicle the history of the support group movement. This history explains how this grassroots health movement came into existence and eventually coalesced into the peak national body for prostate cancer in Australia.

As part of this study the following resources were developed:

A Timeline of the support group movement and history of the PCFA which features on the PCFA website.

A monograph documenting the history of the movement: Mates Helping Mates– A History of Prostate Cancer Support Groups in Australia. 2016. ISBN: 978-0-9945028-4-1

Pathfinder is a national online register for men with prostate cancer and their families interested in participating in survivorship research projects. Pathfinder was established as a joint initiative of PCFA and GU in 2013 and is a key resource of the Centre.

To date, 10 research studies have utilised Pathfinder for recruitment:

Can nutrition therapy with high intensity interval training improve cancer-related fatigue in men with prostate cancer on androgen deprivation therapy? (In progress).

The Men and Sexual Health-Prostate Cancer (MaSH-PC) study (In progress).

A randomised controlled trial of iCanADAPT, an internet Cognitive Behavioural Therapy program for the treatment of depression and anxiety in early-stage cancer patients and cancer survivors (In progress).

Rekindle: testing an online resource to promote sexual wellbeing for both patients and their partners (In progress).

Do Australian men with prostate cancer have access to well-designed websites with quality content information to encourage physical exercise? (Completed).

Applicability of guidelines for management of cancer-related fatigue (Completed).

Sexual wellbeing and quality of life after prostate cancer for gay and bisexual men and their partners (Completed).